Nursing Elites

1. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime
• B. This medication is for the acute management of asthma
• C. Avoid dairy products while taking this medication
• D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up

Correct answer: A

Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.

2. A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?

• A. Liver function tests
• B. Renal function tests
• C. Visual acuity screening
• D. Hearing screenings

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.

3. A nurse is reviewing the medical record of a client who is prescribed acetaminophen for pain. Which of the following lab values should the nurse monitor to identify an adverse effect of the medication?

• A. Serum glucose
• B. Serum creatinine
• C. Serum potassium
• D. Serum bilirubin

Correct answer: B

Rationale: The correct answer is B: Serum creatinine. Acetaminophen is metabolized by the liver, so serum creatinine levels should be monitored for potential hepatotoxicity. Monitoring serum creatinine can help detect liver damage, a potential adverse effect of acetaminophen. Choices A, C, and D are incorrect because serum glucose is not directly affected by acetaminophen, serum potassium is not typically monitored for acetaminophen adverse effects, and serum bilirubin is more related to bile metabolism rather than acetaminophen-induced hepatotoxicity.

4. A nurse is preparing to administer ondansetron to a client. Which of the following therapeutic effects should the nurse expect from this medication?

• A. Decreased nausea
• B. Increased appetite
• C. Increased heart rate
• D. Relief of headache

Correct answer: A

Rationale: The correct answer is A: Decreased nausea. Ondansetron is classified as an antiemetic medication, which means it is used to relieve nausea and vomiting by blocking serotonin in the chemoreceptor trigger zone. Therefore, the nurse administering ondansetron should expect a therapeutic effect of decreased nausea. Choice B, increased appetite, is incorrect as ondansetron does not affect appetite. Choice C, increased heart rate, is incorrect as ondansetron does not have a direct effect on heart rate. Choice D, relief of headache, is also incorrect as the primary therapeutic effect of ondansetron is to alleviate nausea and vomiting, not headaches.

5. A nurse is caring for a client who has been prescribed amoxicillin. Which of the following client history findings requires the nurse to clarify the medication prescription?

• A. Hypertension
• B. Peptic ulcer disease
• C. Asthma
• D. Gastroesophageal reflux disease

Correct answer: C

Rationale: The correct answer is C. Clients with a history of asthma should avoid amoxicillin due to potential hypersensitivity reactions. Amoxicillin can trigger asthma exacerbations in some individuals. Hypertension (choice A), peptic ulcer disease (choice B), and gastroesophageal reflux disease (choice D) are not contraindications for amoxicillin use, so they do not require the nurse to clarify the medication prescription in this case.

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